Clinical case report. Severe central nervous system damage in vitamin K deficiency-related late-onset hemorrhagic syndrome

Zizyukina K.S., Burlakova I.M., Sarkisyan E.A., Zhirkova Yu.V., Vaynshtein N.P., Romanova D.A., Mitina Yu.Yu., Shatalov V.G.

1) Pirogov Russian National Research Medical University, Moscow, Russia; 2) Speransky Children's City Clinical Hospital No. 9, Moscow, Russia

Objective: Presentation of the clinical case of vitamin K deficiency-related late-onset hemorrhagic syndrome in a full-term girl 43 days old who did not receive vitamin K prophylaxis for late-onset hemorrhagic disease of the newborn.
Key points: Vitamin K deficiency-related late-onset hemorrhagic, better known as late-onset hemorrhagic disease of the newborn (ICD-10: P53), is a condition associated with vitamin K deficiency, leading to blood clotting disorders in children aged 8 days to 6 months. Intracranial hemorrhages, which often lead to residual neurological symptoms and death, pose a particular danger in late-onset vitamin K deficiency-related hemorrhagic syndrome. Contraindications to prophylactic administration of menadione (Vicasol) in the maternity hospital and the lack of availability of phytomenadione in the maternity hospital and outpatient care lead to the risk of developing hemorrhagic disease.
Description of the clinical case: This article presents an observation of child V. with vitamin K deficiency-related late-onset hemorrhagic syndrome and severe hemorrhagic central nervous system damage.
Conclusion: Prevention of vitamin K deficiency-related hemorrhagic syndrome is an essential intervention performed in the first hours of a newborn's life. Lack of vitamin K supplementation can lead to severe consequences, as confirmed by our clinical case. The diagnostic and treatment measures performed immediately after the child's admission to the hospital prevented a fatal outcome and achieved minimal neurological impairment.

For citations: Zizyukina K.S., Burlakova I.M., Sarkisyan E.A., Zhirkova Yu.V., Vaynshtein N.P., Romanova D.A., Mitina Yu.Yu., Shatalov V.G. Clinical case report. Severe central nervous system damage in vitamin K deficiency-related late-onset hemorrhagic syndrome. Pharmateca. 2025;32(9):67-74. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.9.67-74

Authors’ contribution: Concept and design of the article – Sarkisyan E.A., Zhirkova Yu.V., Vaynshtein N.P. Data analysis and preparation, text writing – Burlakova I.M., Zizyukina K.S. Scientific editing – Sarkisyan E.A., Zhirkova Yu.V., Vaynshtein N.P., Mitina Yu.Yu., Shatalov V.G.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Patient Consent for Publication: Informed consent for publication of data was signed by the patient’s legal representative.

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About the Authors

Karina S. Zizyukina, Pirogov Russian National Research Medical University, Moscow, Russia; ORCID: https://orcid.org/0009-00059466-1081
Irina M. Burlakova, Pirogov Russian National Research Medical University, Moscow, Russia; ORCID: https://orcid.org/0009-0000-1424-9198
Egine A. Sarkisyan, Cand.Sci. (Med.), Associate Professor, Department of Hospital Pediatrics named after Academician V.A. Tabolin, Institute of Maternal and Child Health, Pirogov Russian National Research Medical University; Speransky Children's City Clinical Hospital No. 9, Moscow, Russia; sarkisian_ea@rsmu.ru; ORCID: https://orcid.org/0000-0001-7305-9036 (corresponding author)
Yulia V. Zhirkova, Pirogov Russian National Research Medical University; Speransky Children's City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0000-0001-7861-6778
Natalya P. Vaynshtein, Pirogov Russian National Research Medical University; Speransky Children's City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0009-0003-3979-7002
Darya A. Romanova, Speransky Children's City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0000-0001-7118-4001
Yulia Yu. Mitina, Speransky Children's City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0009-0002-1820-9956
Vitaly G. Shatalov, Speransky Children's City Clinical Hospital No. 9, Moscow, Russia; ORCID: https://orcid.org/0000-0002-2276-4592

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